Cole, Kim G

Cole, Kim G is an individual health care provider with primary practice located at 202 Lake Miriam Dr Ste S1 , Lakeland FL 33813-2188. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Cole, Kim G can be contacted via phone (863) 647-2333.

Contact Information

Primary practice address
202 Lake Miriam Dr Ste S1 Lakeland FL 33813-2188
Phone: (863) 647-2333
Fax: (863) 393-1995
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 2993 Florida

Profile Details

NPI number 1669453221
LBN Legal business name Cole, Kim G
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Apr 20th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669453221 NPPES
Florida Other PA2993 STATE LICENSE
Florida Other 10679201 STATE LICENSE

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